The use of GABA/l-theanine mixture rather than GABA or l-theanine alone restored to normal levels sleep time and quality in the arousal animal model.

The 10th Annual IMMH Conference will be held in San Diego, at the beautiful Hilton San Diego Bayfront! This four-day international conference gives practitioners a holistic approach to successfully diagnose and treat underlying issues contributing to the manifestations of neurological, behavioral, and psychiatric disorders.

Research has revealed that many disorders such as depression, bipolar disorder, anxiety, OCD, eating disorders, and autism spectrum disorders often have biomedical causes that contribute to symptoms, from nutritional deficiencies to chronic infections. Patients have better outcomes when these causes are addressed and treated through a combination of specialized testing and nutritional therapies, even in combination with traditional approaches.

CME, CE, and CEU credits available!

It’s my favorite integrative mental health conference and this year the speaker line-up and topics being addressed are excellent!

Brains on Fire: An Integrative Approach to Healing Childhood PANS/PANDAS

Integrative Therapies for Suicide Prevention

Reversal of Cognitive Decline: The Science, The Tools, and the Transformation

Concussion Rescue: A Comprehensive Approach to Traumatic Brain Injury

Neuropsychiatric Aspects of Lyme Disease and Associated Co-Infections

Non-Pharmacological Treatments for Chronic Pain

The Integrative Treatment of ADHD

Bioidentical Hormone Replacement for Mood and Cognition

New Frontiers in Mental Health: CBD and Beyond

IMMH CLINICIAN REGISTRY

Attendance at this conference qualifies you to join the Integrative Medicine for Mental Health (IMMH) Clinician Registry, making you accessible to potential patients. Each entry searchable by zip code in the U.S. and provides the medical professional’s specialty and contact information. In keeping with the integrative approach, the registry includes all professionals who have attended an IMMH conference and completed the IMMH registry application.

If you are coming, please comment below and let me know! And be sure to come and say hi after my presentation and at my booth! If there is enough interest, I’ll be arranging a gathering/dinner one evening so let me know.

This is a practitioner-only event so if this doesn’t apply to you please consider sharing it with your practitioner. I’ll also be bringing back information to share with you via blog posts after the event so stay tuned. In the meanwhile, feel free to post questions in the comments below.

As I prepare for “The Anxiety Summit 5: Gut-Brain Axis” (airing in November 2019) I have been going through interviews from the first Anxiety Summit in 2014 and would like to share something that I addressed in my opening interview as a good recap for you as you are on your healing journey with anxiety (or in case this comes up again in the future) – you truly can eliminate anxiety entirely!

This is a question I am often asked: “Can I really eliminate anxiety using food, nutrients (and a functional medicine approach) if I have very severe anxiety and/or panic attacks and I’m using medications?”

Way too many folks don’t believe it’s possible but yes, you can! You can completely eliminate full blown anxiety, panic attacks, social anxiety (where you cannot go out to social event or go and feel so anxious), phobias like fear of spiders or agoraphobia (where you cannot get out of the house), and even obsessive-compulsive disorder (OCD).

Many folks believe their anxiety is much too severe and that food and nutrients couldn’t possibly help. I’m here to tell you this is just not true.

It’s not uncommon for well-known thought leaders to perpetuate this myth, implying anxiety and fears never go away.

Ali Brown, entrepreneurial guru for women, and one of my amazing business mentors, created a program to help businesswomen overcome their fears. She shared this in the program information: “Let’s not forget women’s darkest best friends: anxiety and worry” and admitted “I still have to fight it. I come from a long line of worriers.”

I say no, you don’t have to fight it. Just because you come from a long line of worriers doesn’t necessarily mean that you have to put up with it and live with it. There is something you can do to eliminate the anxiety, worries and fears.

I really want you to know this, remember this, and don’t stop looking for the answer and the root causes. It may be food changes that you need to make. It may be breakfast that you need to eat. It may be low serotonin or low GABA. It may be foods that are problems for you like gluten or dairy. It may be additives in the foods that you’re eating. It may be toxins in your environment. There are many possible root causes, and you may have one or many root causes that are causing your anxiety.

Addressing these root causes with food and nutrients (and a functional medicine approach you can completely eliminate your anxiety even if you have very severe anxiety and/or panic attacks and you’re using medications.

Resources for you

My book The Antianxiety Food Solution (my Amazon affiliate link) covers the 9 steps I use with clients. Read it and become a savvy health-advocate for yourself. Share a copy with your doctor and point out the references.

I recently received a question about the possible connection between pectus excavatum and pyroluria, a social anxiety condition. In layman’s terms, pectus excavatum is a depression or indentation in the chest wall and is related to problems with connective tissue. This Medscape article describes it as follows:

Pectus excavatum, also known as sunken or funnel chest, is a congenital chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest wall.

It’s not something I’m familiar with other than seeing someone with this condition at the beach once (I share some pictures below) and when doing the research for this blog.

In case you’re new to pyroluria, it is a genetic condition that is frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress. You can read more about it here.

There are also connective tissue symptoms with pyroluria with the following commonly a factor: joints popping, cracking, or aching; pain or discomfort between the shoulder blades; and/or cartilage problems. This is often due to low levels of zinc. Here is the entire pyroluria questionnaire.

Addressing low levels of the mineral zinc and vitamin B6, together with some other nutrients and stress management, are key to addressing pyroluria symptoms. The social anxiety can typically be lifted in a week and the joint and pain problems often ease in 1 to 2 months.

So now that I’ve set things up with an overview of pyroluria and EDS and the connective tissue problems, let me share what I uncovered about pectus excavatum and why I feel there is very likely a connection with pyroluria.

Pectus excavatum (PE) … is the most common chest wall deformity, representing 90% of all cases. Depending on the severity of PE, deviations of thoracic organs and spine deformities are known. Although PE in most instances has little or no influence on the function of the inner organs, the cosmetic appearance of the patients leads to psychological impairment which requires therapy.

In the above paper, they write about one of the hypotheses: weak cartilage through metabolism dysfunction. They report decreased levels of zinc in the pectus excavatum patients, suggesting “the lack of zinc in the diet results in a lower metabolic activity of chondrocytes.” Chondrocytes are cells found in cartilage connective tissue. In summary, one hypothesis is that low dietary zinc affects cartilage connective tissue in some individuals with pectus excavatum.

Observe the mention of psychological impairment. Could the low zinc be playing a role in this too? I address this below.

Pectus excavatum and Ehlers-Danlos, plus dental crowding

It seems clear that several patients affected by pectus excavatum display a typical association with connective tissue disorders, which may span from mild form like simple laxity without morbidity associated, to more severe forms such as MFS and Ehlers-Danlos syndrome

This paper also mentions “Highly arched palate with dental crowding” which is common in pyroluria and seems to be related to low levels of zinc.

The image below illustrates a moderate/severe form of pectus excavatum.

Chest picture of an adolescent affected by a moderate/severe form of pectus excavatum. Written consent was obtained from the patient and the patient’s parents for publication of this image.

Vitamin B6 and high homocysteine

With regards to vitamin B6, one of the other key nutrients needed for pyroluria, one paper, Pectus carinatum repair in an adolescent with hyperhomocysteinaemia: Anaesthetic implications reports a case of a 14-year-old boy with high homocysteine. his level was 18.5 μmol/l (normal levels are within 7–10 μmol/l). He was treated with folic acid, Vitamin B6 and B12 supplements. Is this common in all cases of chest wall deformities? I don’t know but it would interesting to find out.

It’s understandable that the physical manifestations of this condition would lead to some of these feelings but I have to question how much of this could also be related to low zinc and low vitamin B6. Both nutrients are needed for easing pyroluria/social anxiety symptoms and making neurotransmitters such as serotonin.

Other than trying to make some connections with the research, when this question was asked on facebook, a number of people said they (or a family member) has both pyroluria and pectus excavatum.

If you do have pectus excavatum and pyroluria, getting on the pyroluria protocol will:

ease some of the social anxiety and depressive symptoms

very likely lead to less pain and discomfort

very possibly prevent further connective tissue issues

feasibly prevent pectus excavatum in future children or perhaps reduce the severity in the instance where zinc is a factor (this one is a long shot that I feel is worth further research)

I’d love to gather more information and am looking for feedback so please do share your symptoms and experiences in the comments. Let us know if you or your child or other family member has pectus excavatum and any of the following:

A score 15 or more on the pyroluria questionnaire and/or suffer from social anxiety

Have low zinc

Have low B6 (poor dream recall or nightmares is a clue)

Have high homocysteine i.e. above 10 μmol/l

Ehlers-Danlos syndrome or joint hypermobility

Dental crowding

Resources for you

My book The Antianxiety Food Solution (my Amazon affiliate link) has an entire chapter on pyroluria. Read it and become a savvy health-advocate for yourself. Share a copy with your doctor and point out the references.

Today I’m sharing some great questions I’ve received about GABA and serotonin support for anxiety and low mood, and my feedback to give you some ideas on what to look for as you use the amino acids for your own issues (or with clients/patients if you’re a practitioner).

I cover possible reasons for ongoing low GABA levels, long-term use of the amino acids, low mood associated with menopause, problems with mainly sugar- and gluten-free, the role of the adrenals and thyroid, the amino acids I’d start with for low mood, how lithium orotate may help, how to know if collagen is causing a low mood and making you more anxious, and some resources for you.

GABA tolerance has increased

Gaba has been a lifesaver for my anxiety! I also use taurine sometimes for anxiety too, and that has helped too. Right now, I take 1000 mg [of taurine]. As for GABA (I now take 1000 mg of that also) I have noticed that my tolerance for it has increased.

Here is my feedback: I’m really pleased GABA and taurine are helping ease your anxiety. I have not seen tolerance to be a factor with my clients using GABA and I’m not aware of any research on this topic. I would look into what could be depleting GABA at a faster rate so you seem to need more and more.

This could be caused by:

increased stress which lowers zinc and increases cortisol

poor gut health and dysbiosis (there is a bacteria in the gut that may consume GABA – it’s called gabavorous)

low zinc and low B6 (which are needed to make GABA and other neurotransmitters)

thyroid problems (the amino acids are less effective in this instance)

Keep in mind that long-term use of the amino acids is not the plan. Once the diet is addressed and the other underlying biochemistry, nutrient deficiencies, toxins etc. are addressed they should no longer be needed. At most, an occasional “top-up” may be needed.

Low mood associated with menopause

Which amino acids would you recommend for low mood associated with menopause? No panic attacks but a crashing low mood for 24hrs or more before slight recovery, a few easy days and then the cycle begins again. Diet is mainly sugar- and gluten-free. Any suggestions would be appreciated, thank you

Here is my feedback: When I hear “diet is mainly sugar- and gluten-free” with mood swings I always look into gluten exposure and blood sugar dips. Keeping a food mood log is an easy first step to see if the low mood is tied to what is being eaten and when.

I would recommend the complete removal of gluten and sugar. Gluten can trigger depression, anxiety, OCD and lead to many psychiatric symptoms. Blood sugar swings can cause both depression and anxiety. The amino acids make it easy to quite sugar and gluten – no willpower required and no feelings of deprivation. Do the questionnaire and do a trial of the amino acids that apply. Based on the above symptoms I’d suspect tryptophan and tyrosine may help and are always a good first step while everything else is being figured out.

I would also look at adrenal function as they take up the slack in menopause and rule out Hashimoto’s thyroiditis and Graves (as you can get mood swings with both as the thyroid levels shift).

Low lithium can also cause mood swings too and lithium orotate can help to keep an even mood, allowing the amino acids to be more effective.

Next steps are a full workup looking at sex hormones, low zinc, low B6, low magnesium, the gut, EMFs, sleep and other dietary factors like salicylates, histamine, glutamates etc. We look at all the possible 60+ nutritional and biochemical root causes and address them or rule them out.

It’s also important to have a good support system in place for those very low days – friends and family members, being part of a community and even keeping a mental health support line number close at hand.

And of course, I always say this: get out in nature, get some exercise, hug someone and have a good laugh.

Resources for you

My book The Antianxiety Food Solution (my Amazon affiliate link) has an entire chapter on the amino acids GABA, tryptophan, tyrosine, and DPA (and how to use them), a chapter on blood sugar balancing and glutamine and a chapter on gluten issues (and much more). Read it and become a savvy health-advocate for yourself. Become someone who is well-informed about the amino acids, the precautions and nuances, and all the nutritional approaches for anxiety-relief. Share a copy with your doctor and point out the references.

If figuring it out alone or reading my book feels overwhelming to you, or you’re afraid to use the amino acids on your own, my home-study Amazing Aminos for Anxiety program walks you through a step-by step approach on how to figure out which symptoms are tied to which neurotransmitter deficiency, and how to trial each respective amino acid. Stay tuned for a special upcoming launch with live Q and A calls so you can get your questions answered. (If you have recently purchased the homestudy ONLY version we will be contacting you to invite you to participate.)

Can you relate to either of these questions? And are you good at playing a detective to figure out why something may not be working as expected?

What has worked for your anxiety and/or low moods?

Feel free to post questions in the comments too.

And let me know if you’re interested in the homestudy program with live Q and A calls. (If you have recently purchased the homestudy ONLY version we will be contacting you to invite you to participate.)

Toxin exposure is at an all-time high and very relevant when it comes to anxiety, ADHD, asthma, diabetes, cancer, dementia and all chronic diseases. I did this wonderful interview with Dr. Joseph Pizzorno in 2017 when his book – The Toxin Solution – was published and for some reason it didn’t make it onto the blog.

If you’re planning to attend this will give you a taste of what to expect. If you’re on the fence hopefully this will convince you, together with the fact that I’m presenting again this year (I’m doing a deep dive into GABA).

I look forward to meeting him in person at the conference and will hopefully see you there too! If you can’t make it or are not a practitioner enjoy this interview and do checkout his fabulous book.

Read on for notes from our interview, the video interview and resources for you related to our interview. Some highlights include these facts: about 90% of diabetes is just due to 6 toxins; PCBs (polychlorinated biphenyls) may account for half of all breast cancer; top 10% of those exposed to organophosphate pesticides saw a doubling of ADHD (just one pesticide); 20% of osteoporosis in women is due to cadmium; lentil soup in a can has 10 x more BPA than homemade and much more

in mid to late-70s people were sick because of nutritional deficiencies, lack of exercise and lifestyle factors

we have polluted our air, water, food, health and beauty aids, household cleaning products, products in our yards – independent of what you do, toxins are coming in

he worked with big oil company in Canada – they wanted to improve the health of the staff and he ran tests to measure nutritional status and toxin levels ($1500 worth of lab tests of 4500 people) – saw a lot of toxicity

top 20% of those with body burden of toxins vs bottom 20% – what is disease risk? very big increase in disease risk

diabetes as example – when he was in medical school 50 years ago diabetes affected 1% of the population and now it’s 20-30x more common

looked at data on diabetes and toxins – looked at organochlorine pesticides – used widely in our food supply

top 10% of those with high body burden – 12 fold increase risk of diabetes

looked at many other diseases and all had high correlation of toxicity with higher risk

used his book advance to hire researchers (Bastyr grads) to determine what toxins contribute to what diseases

about 90% of diabetes is just due to 6 toxins

it’s why he wrote this book The Toxin Solution (my Amazon link) – here’s how toxins cause disease, here’s where the toxins are coming from, here’s how you avoid them and here’s how you prepare your body for a detox (do this first) and then do the detox

[I shared my exposure to lead when I worked in an oil refinery before I became a nutritionist]

oil field workers he tested were never exposed to the oil itself as it was underground – they were also farmers and spaying with pesticides, herbicides and insecticides

everyone can relate to how dangerous smoking is i.e. lung cancer is doubled by smoking and it affects 20-25% of the population, so bring it home for people asked if there are other toxins that increase the risk of certain diseases – answer is most certainly yes

asthma – Polycyclic aromatic hydrocarbons (PAHs) from second-hand smoke, city living, diesel, barbecue smoke; 93% of the US population have enough PAH exposure to double their risk of asthma

increase your fiber intake – liver denatures toxins by binding them to another molecule and dumps them into the gut where they are bound to fiber and excreted but 90% of toxins get reabsorbed through enterohepatic circulation because we now only consume 15-20g of fiber a day. You need at least 40-50g of fiber a day to detox

if you do nothing more than consume more fiber you will get the toxins out – it’s very slow but you will get the toxins out

flax seeds, oats, alginate, pectin

not a fan of wheat fiber – most of his patients don’t tolerate wheat

any kind of fiber that mixes in water and gels – this is good

NAC (N-acetyl cysteine) – the cysteine promotes the production of glutathione (most important intracellular and intra-mitochondrial antioxidant

glutathione is also part of process in the liver where it binds chemical toxins in order to neutralize them and dump them into the gut to get rid of them

as little 500mg/day of NAC can help your body get rid of toxins

next is sweat – saunas and running, but not steam-baths as this recirculates stuff – your sweat is full of toxins

[I have a question about the toxin-filled sweat on the towels and in the sauna]

air out the sauna and wash the towels but it’s not ideal because then we’re putting those toxins back into the environment (can burn them or bury them but there is no good solution) – best to stop putting chemicals into environment

[I have a question about an indoor saunas and toxins going into the home]

A few weeks ago I blogged about a new pilot study about the use of a skin moisturizer twice a day reduced inflammation in older adults. I use the inflammation research to question if this may be applicable and helpful for you if you suffer from anxiety, extrapolating that it may well be given the added benefits of touch and an oxytocin boost.

I received a number of great questions about how to apply this information and have decided to share a question from someone with both Sjogren’s syndrome and anxiety, in order to illustrate how I’d work with someone like this.

Here is the question I received:

I would like to know how much of one’s body needs to be moisturized, and if it is also necessary to be done twice per day? Such a simple but effective way to help with anxiety. Will be slathering a lot more in the future! I have Sjogren’s so everything is dry – skin, mouth, eyes, hair. I have been trying to keep my face much “moister” and I am sure my wrinkles have lessened. I find rice bran oil is also quite good.

I’m going to address her moisturizing question below and share more about anxiety in Sjogren’s syndrome and some nutritional solutions, but first let me explain what Sjogren’s syndrome is.

An overview of Sjogren’s syndrome

Let me explain what Sjogren’s (SHOW-grins) is in case you’re not familiar with this condition. It’s an autoimmune condition and is described as follows on the Mayo Clinic site:

often accompanies other immune system disorders, such as rheumatoid arthritis and lupus. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first — resulting in decreased tears and saliva.

Although you can develop Sjogren’s syndrome at any age, most people are older than 40 at the time of diagnosis. The condition is much more common in women.

The site goes on to say that other than dry eyes and mouth, some people experience joint pain and stiffness, swollen salivary glands, skin rashes or dry skin, vaginal dryness, persistent dry cough and prolonged fatigue. It’s worth a read to learn more about complications like more dental cavities, yeast infections, vision issues, problems in the lungs, kidneys or liver, the risk of lymphoma and peripheral neuropathy.

My feedback about moisturizing

In the study, moisturizing was done twice a day. I’m not sure how much of the body needs to be moisturized but if everything is dry, I’d want to moisturize as much as possible.

Given that chronic inflammation is a major factor in Sjogren’s and other autoimmune conditions like systemic lupus erythematosus, it’s feasible to expect similar benefits in terms of reduced inflammation. Hopefully we’ll see research on autoimmune conditions in the future.

When it comes to anxiety, I do want to make it clear that I was and still am extrapolating from the research on inflammation and measuring reduced anxiety was not part of the study. Moisturizing may or may not help with anxiety and I certainly wouldn’t only use this intervention.

Anxiety in Sjogren’s – low serotonin and GABA?

You may not be aware that anxiety/depression is very common in Sjogren’s. In one study they

found 33.8% patients with anxiety, and 36.9% had depression, which were significantly higher than controls.

I use a comprehensive nutritional and lifestyle approach to help my clients ease their anxiety and as I mention above, I would not only rely on moisturizing.

They didn’t find a correlation between the levels of serotonin and how severe the Sjogren’s symptoms were, which falls in line with what we know about biochemical individuality and why doing a trial of tryptophan or 5-HTP (to find your ideal dose) is the best approach for serotonin support.

If you recall, in the Mayo Clinic description above, stiffness is a common symptom of Sjogren’s and GABA eases stiffness.

I haven’t found any research on GABA in Sjogren’s, but one case study reports that a patient experiencing athetoid movements (a movement dysfunction, characterized by involuntary writhing movements), reported symptom improvement with hydroxychloroquine, pilocarpine, gabapentin, and clonazepam. The latter two medications work on the GABA system.

If you recall, in the Mayo Clinic description above, joint pain and dental cavities are common symptoms. These are also very common with pyroluria, so using a nutritional approach helps ease the social anxiety, and improves joint issues and mouth health.

Sjogren’s and the Autoimmune-Paleo diet

Since Sjogren’s is an autoimmune condition, following an Autoimmune-Paleo (AIP) diet is key too. Here are some books that are well-worth making part of your library, even though they are not specific to Sjogren’s syndrome they offer support for autoimmune conditions (and many individuals often have more than one autoimmune disease)

Here is one more resource for you: The Autoimmune Masterclass which airs online this weekend It’s a similar format to online 7-day summits but runs for 2 days instead and is no-cost to attend during these two days.

I haven’t dived into the research on all the other autoimmune conditions and the above connections (low serotonin, low GABA and pyroluria) but it’s highly likely similar connections exist. So, if you have any autoimmune condition and anxiety this could all apply for you too.

If you have been diagnosed with Sjogren’s syndrome please share if GABA and tryptophan have helped ease your anxiety, and if the pyroluria protocol has helped you with social anxiety?

And let us know if moisturizing is helping your dry skin and possibly reducing inflammation and anxiety too?